Washington, D.C. – The Senate Judiciary Committee today explored a major barrier to improved health outcomes and cost savings in the health care system – the federal prohibition on electronic prescribing of controlled substances. The hearing was chaired by U.S. Senator Sheldon Whitehouse (D-R.I.), a former prosecutor and strong advocate for health information technology.
“Health information technology’s potential for better-coordinated care, reduced medical errors, and increased patient satisfaction and peace of mind is enormous,” Whitehouse said. “We have to tackle the roadblocks that prevent this extraordinary technology from being available nationwide.”
Allowing doctors to write and submit drug prescriptions electronically costs less, saves time, and helps avoid dangerous medical errors and drug interactions.
E-prescribing, used today in about 18 percent of doctors’ practices, is often cited as a necessary first step towards a national health information technology infrastructure.
Studies show a fully-operational health IT system could generate an estimated $80 billion in health care savings each year. E-prescribing alone could save $20 billion annually, as patients would experience fewer adverse drug events (ADEs) and would be more likely to adhere to a medication regimen. The Center for Information Technology Leadership (CITL) found that a national e-prescribing system could prevent 2.1 million ADEs – 130,000 of which are life-threatening – and 190,000 hospitalizations per year.
But federal rules governing dispensation of controlled substances such as pain medications, antidepressants and some drugs used to treat asthma in children require that doctors write paper prescriptions for these pharmaceuticals. The result is that most doctors resort to writing all their prescriptions by hand rather than maintain a paper system for controlled substances and an electronic system for non-controlled substances. The Drug Enforcement Administration (DEA), the agency responsible for investigation and prosecution of crimes involving the illicit use of controlled substances, has been developing regulations to allow e-prescription for controlled substances for more than four years. They have offered no deadline for completion of these regulations.
“Billion-dollar transactions are done electronically; highly classified national security information travels electronically; military attack aircraft are targeted electronically. Don’t tell me we can’t figure out a way for a doctor to prescribe Vicodin electronically,” Whitehouse said.
In October, during consideration of a bill appropriating funds for DEA and the Justice Department, Whitehouse engaged in a Senate floor colloquy with Appropriations Subcommittee Chairman Barbara Mikulski (D-Md.), Health, Education, Labor, and Pensions Committee Chairman Edward M. Kennedy (D-Mass.), and Senator Debbie Stabenow (D-Mich.) to discuss electronic prescribing for controlled substances. During that colloquy, Whitehouse proposed a joint report by the DEA and the Department of Health and Human Services assessing the status of rule changes that would permit this practice.
Today’s hearing, Whitehouse said, is an opportunity to hear from federal regulators and health information technology experts on the progress of rule-making in this area and the potential benefits and challenges of an e-prescribing system for controlled substances. Witnesses included Laura Adams of the Rhode Island Quality Institute, an organization Whitehouse founded that is a leader in the state’s efforts to improve health care quality and health information technology utilization.
Whitehouse served as U.S. Attorney for the District of Rhode Island from 1994-98 and as the state’s Attorney General from 1999-2003. A longtime supporter of health information technology, he has introduced Senate legislation to establish a private, non-profit corporation tasked with developing a national, interoperable, secure health IT system (S. 1455).
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